Retrospective Evaluation Of 60 Cases Of Intracranial Aneurysms

Yıl 2010, Cilt: 4 Sayı: 1, 227 - 235, 21.03.2010

Giyas Ayberk

Öz

Subarachnoid hemorrhage is a multifactorial cerebrovascular disease that occurs in every age group and the rupture of aneurysm is the most common cause of strokes. In this study, we have investigated the clinical and neuroradiological findings and surgical results of the intracranial aneuryms treated at our clinic retrospectively.
Sixty patients with intracranial aneurysms presented with subarachnoid hemorrhage had been operated on between January2006 and April 2009 at Ataturk Training and Research Hospital Department of neurosurgery. Patients operated were evaluated according to the preopeative findings and surgical outcomes.
The female-male ratio was 3/2 and the age distribution was between 17 to 77 with mean 53,5. The most common aneurysm localization was middle cerebral artery. In 10% of the patients aneurysms were multiple. In 93,2 % of the patients early surgery and in the 6,8% of patients late surgery were performed. Endovascular surgery was carried out in one patient by way of aneurysm coiling.
It has been pointed out in our study that vasospasm developed in 27,6 % of the patients operated early and in 53,8 % of the patients operated late. It has also been shown that this case of vasospasm is more prevalent in Anterior Communicating Artery aneurysms and grade 3 aneurysms according to WFNS grading system. In patients operated on early prognosis was better regarding morbidity and mortality.

Anahtar Kelimeler

Aneurysm, Dissecting; subarachnoid hemorrhage; vasospasm, intracranial

İntrakranial Anevrizmalı 60 Olgunun Geriye Dönük Olarak Değerlendirilmesi

Öz

Spontan subaraknoid kanama birçok nedene bağlı, her yaşta görülebilen serebrovaskü-ler bir olaydır ve en sık nedenini intrakranial anevrizmalar oluşturmaktadır. Bu çalışmada tedavi edilen intrakranial anevrizma vakalarının klinik ve nöroradyolojik özellikleri ve cerrahi sonuçları literatür ile karşılaştırılarak incelenmiştir.

Atatürk Eğitim ve araştırma Hastanesi II. Nöroşirürji Kliniği’nde Ocak 2006 ve Nisan 2009 tarihleri arasında subaraknoid kanama geçiren 60 hastada intrakranial anevrizma tespit edilerek ameliyata alınmıştır. Preoperatif nörolojik tablo ve çıkış skalaları değerlendirilerek erken ve geç cerrahi uygulanan hastalar mevcut bulgular ile retrospektif olarak incelenmiştir. Kadın erkek oranı 3/2 idi. Yaş dağılımı 17 ile 77 arasında olup ortalama yaş 53,5 olarak tespit edildi. En sık anevrizma yerleşimi orta serebral arterdeydi. Hastaların 10’unda (% 16,9) çoğul anevrizma mevcuttu. Olguların %93,2’sine erken cerrahi, %6,8’ne geç cerrahi uygulanmıştır. Bir olguda endovasküler cerrahi yapıldı.

Operasyon zamanı ve Glasgow sonuç skalası incelenerek yapılan çalışmada erken cerrahi uygulanan hastaların % 27,6’sında, geç cerrahi uygulanan hastaların ise % 53,8’inde vazospazm geliştiği, vazospazmın en sık Anterior Kominikan Arter anevrizmaları ve Dünya Nöroşirürjiyen-ler Topluluğu skorlamasına göre grade 3 anevrizmalarda görüldüğü çalışmamızda gösterilmiştir. Erken cerrahi yapılan hastalarda; morbidite ve mortalite açısından prognozun daha iyi olduğu görüldü.

Dr. Giyas AYBERK
Dr. Alpaslan EYLEN
Dr. Mesut Emre YAMAN
Dr. Timur YILDIRIM
Dr. Hakan TOSUN
Dr. NaciALTUNDAL
Dr. Erdem GÜRKAŞ Dr. M. Faik ÖZVEREN

Anahtar Kelimeler

Anevrizma, disekan; subaraknoid kanama; vazospazm, kafa içi

Kaynakça

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